https://repository.auw.edu.bd/handle/123456789/716 2026-06-09T23:47:52Z 2026-06-09T23:47:52Z Chowdhury, Mohiuddin Ahsanul Kabir https://repository.auw.edu.bd/handle/123456789/881 2026-02-18T06:15:18Z 2020-01-01T00:00:00Z

Are childbirth location and mode of delivery associated with favorable early breastfeeding practices in hard to reach areas of Bangladesh? Chowdhury, Mohiuddin Ahsanul Kabir Background Early initiation of breastfeeding within one hour of birth (EIBF) and no prelacteal feeding are WHO recommended practices for improving maternal and newborn health outcomes. Glob- ally, EIBF can avert around 22% of newborn death. In recent years, Bangladesh has experi- enced increasing facility delivery coverage and cesarean section rates. However, the impact of these changes on early breastfeeding initiation in hard to reach areas (HtR) of the country is still poorly understood. Therefore, this study aimed to examine the independent associations between childbirth locations and mode of delivery with favorable early breast- feeding practices in four hard to reach areas of Bangladesh. Method We extracted data from a cross-sectional study conducted in four HtR areas of Bangladesh in 2017. A total of 2768 women, having birth outcomes in the past 12 months of the survey, were interviewed using structured questionnaires. EIBF and no prelacteal feeding were con- sidered as favorable early breastfeeding practices. The categories of childbirth locations were defined by the place of birth (home vs. facility) and the delivery sector (public/NGO vs. private). The mode of delivery was categorized into vaginal delivery and cesarean section. Generalized linear models were used to test the independent associations while adjusting for potential confounders. Results The prevalence of EIBF practices were 69.6%(95% CI:67.8–71.3); 72.2%(95% CI:67.8– 71.3) among home births Vs 63.0%(95% CI:59.5%-66.4%) among facility births. Around 73.9% (95% CI:72.3–75.6) mother’s in the study areas reported no-prelacteal feeding. Compared to home births, women delivering in the facilities had lower adjusted odds of EIBF (aOR = 0.51; 95%CI:0.35–0.75). Cesarean section was found to be negatively associ- ated with EIBF (aOR = 0.20; 95%CI:0.12–0.35), after adjusting for potential confounders. We could not find any significant associations between the place of birth and mode of deliv- ery with no prelacteal feeding. Discussions This study found that facility births and cesarean deliveries were negatively associated with EIBF. Although the implementation of "Baby-Friendly Hospital Initiatives" could be a poten- tial solution for improving EIBF and no prelacteal feeding practices, the challenges of reduced service availability and accessibility in HtR areas must be considered while devising effective intervention strategies. Future studies can explore potential interventions to pro- mote early breastfeeding for facility births and cesarean deliveries in HtR areas.

2020-01-01T00:00:00Z Chowdhury, Mohiuddin Ahsanul Kabir https://repository.auw.edu.bd/handle/123456789/880 2026-02-18T06:15:30Z 2020-01-01T00:00:00Z

The Interaction of Adverse Childhood Experiences and Resiliency on the Outcome of Depression Among Children and Youth, 8-17 year olds Chowdhury, Mohiuddin Ahsanul Kabir Background—Adverse childhood experiences (ACEs) are common among children. Little is known on how resilience factors and positive childhood experiences (PCEs) may moderate the relationship between ACEs and childhood depression. Objective—Our study fills this gap by providing recent, nationally representative estimates of ACE and PCE exposure for ages 8-17 and examines the associations between ACE exposure and PCEs on the outcome of depression. Participants and Setting—Data were drawn from the nationally representative 2016-2017 National Survey of Children’s Health (NSCH) and included a total sample of 40,302 children and adolescents. Methods—Chi square analysis and multivariate logistic regressions were performed to assess associations of depression with 9 ACE and 6 PCE exposures. Additive and multiplicative interactions were examined between ACE exposure and PCEs (resiliency measures) on depression. Survey sampling weights and SAS survey procedures were used. Results—Our study found that 4% of children had current depression and those with an ACE count greater than four had increased odds (aOR: 2.29; CI: 1.74-3.02). Multivariate regressions demonstrated associations between depression and low resiliency as well as significant interactions between ACE exposure and three PCEs. Children who were exposed to greater than four ACEs and did not exhibit resilience had 8.75 higher odds of depression (CI: 5.23-14.65) compared to those with less than four ACEs and some resilience. Conclusions—These findings illustrate the need for the promotion of PCEs and the building of resiliency for combatting depression and reducing the impact of trauma in children and adolescents.

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